Enlarged uterus and endometrial thickness up to 2cm (limit decreases with increasing time since delivery)
No color doppler flow in endometrium
No intracavitary mass
No complex fluid in uterine cavity
Endometritis:
Mostly clinical dx
Thickened, heterogeneous endometrium
Intracavitary fluid
Intracavitary air (but present in 21% of normals)
Color doppler flow in endometrium
Uterus can appear normal.
Most common reason for post-partum fever
Retained Products of Conception: (RPOC)
If endometrium <1 cm, RPOC unlikely.
RPOC 45% without flow
RPOC > 90% with thickening and color flow
If flow is in endometrium this is NOT AVM/AVF; call RPOc
AVM/F have flow isolated to myometrium
Imaging overlap with endometritis and hemorrhage from uterine atony (atony usually directly postpartum, RPOC bleeding usually later)
PPV: Positive predictive value
Normal:
Endometritis:
Retained Products of Conception: (RPOC)
- If endometrium <1 cm, RPOC unlikely.
- RPOC 45% without flow
- RPOC > 90% with thickening and color flow
- If flow is in endometrium this is NOT AVM/AVF; call RPOc
- AVM/F have flow isolated to myometrium
Imaging overlap with endometritis and hemorrhage from uterine atony (atony usually directly postpartum, RPOC bleeding usually later)PPV: Positive predictive value
Ref: The Sonographic and Color Doppler Features of Retained Products of Conception
http://edus.ucsf.edu/sites/edus.ucsf.edu/files/wysiwyg/Durfee%20Retained%20POC.pdf
Imaging the Endometrium: Disease and Normal Variants
http://radiographics.rsna.org/content/21/6/1409.long